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  • Title: [Investigation of the gonadotrophins and prolactin in sterile men (the LH-RH + TRH test) (author's transl)].
    Author: Boucher D, Hermabessiere J, Grizard G, Doly M, Bruhat M.
    Journal: Rev Fr Gynecol Obstet; 1977 Oct; 72(10):631-40, 641-4. PubMed ID: 413178.
    Abstract:
    118 sterile men and 12 normal control patients, aged 20-38, were tested to determine the effect of luteinizing hormone-releasing hormone (LH-RH) on the gonadotropin levels and thyroid releasing hormone (TRH) on the prolactin level. The 118 sterile men were classified as suffering either from moderate oligospermia or excretory zoospermia (Group 1) or severe secretory oligo- or azoospermia due to blockage of spermatogenesis (Group 2).. Group 1 was divided into 38 eugonadotropes, 21 hypogonadotropes, and 13 hypergonadotropes; Group 2 consisted of 19 cases of blockage at the sperm acyte 2 or spermatide levels (Group 1a), 11 cases of blockage at the sperm ozonia or spermacyte 1 levels (Group 2a), and 10 cases of bilateral chrypt-orchidy of isolated Sertoli cells (Group 3a). 4 cases of Klinefelter's syndrome and 2 cases of testicular feminization wereaalso studied. Basal values of LH were significantly higher in Group 3a. After administration of 50 mcg of LH-RH iv, the LH values peaked after 20-30 minutes, except for Group 3a and the men with Klinefelter's syndrome and testicular feminization. The follicle stimulating hormone (FSH) basal values were significantly higher in Group 2. Maximum FSH values occurred 30-45 minutes after the LH-RH injection; the response took longer for hypogonadotropes and was very irregular in Group 3a and those with Klinefelter's syndrome. Prolactin levels of the patientswwere taken before and after administration of 200 mg of TRH iv. About 40% of the sterile men exhibited elevated prolactin levels before or after the injection. Testicular biopsies, semen analyses, and other parameters were measured. Of the cases where gonadotropin levels remained normal afte LH-RH administration, a pathological reason for sterility could be found for only 213 of the sterile men. Of the patients with low basal gonadotropin levels or weak response to LH-RH, 1/2 had diabetes or hemochromatosis. Of the patients who had strong LH responses and normal FSH responses to LH-RH administration, 1/2 had elevated prolactemia. A correlation between prolactin secretion and androgen secretion and a negative correlation between prolactinemia and the number of sperm/ml were found.
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